American College of Cardiology

Liability Reform Bill Moving Toward House Vote
Three House committees have approved the HEALTH Act, an ACC-supported medical liability reform bill, setting the stage for formal consideration of the bill by the full House later this week. ACC members are encouraged to contact their lawmakers and urge them to support this bill. An all-member alert on this issue with talking points was sent out earlier today. Members can easily contact their members by phone by calling 1-800-335-4860. Callers will be prompted for an access code. ACC members should use 2273.

ACC members can also contact their legislators via email using the ACC's grassroots advocacy tool. Go to the ACC Web site and click on the "Take Action Now" icon. When prompted, type in your ACC user name (last name) and password (ACC member ID number). Click on "medical liability reform." Talking points and fact sheets on this issue are available in the ACC medical liability reform resource center.

New Reports Show Expansion, Impact of Liability Crisis
As legislators continue to grapple with liability reform legislation, two new reports released last week catalogued the extent of the liability crisis and its mounting impact on communities. The Department of Health Human Services (HHS) released a report linking growing problems in health care to the liability issue, especially access to care. "More doctors, hospitals, and nursing homes are facing increasing difficulty in obtaining insurance against lawsuits, and as a result more patients are facing greater difficulty in obtaining access to doctors," the report states. In addition, the American Medical Association added six more states to its list of states facing a liability crisis, bringing the total to 18 states.

House to Vote on Medical Error Reporting Bill
The House of Representatives is expected to formally consider early this week the "Patient Safety Improvement Act," a bill that would create "patient safety organizations" to which health care providers would voluntarily and confidentially submit reports on medical errors. Under the legislation, legal protections would be offered to those who submit error reports and a database would be created to track national trends and reoccurring problems. This same bill was introduced in both the House and Senate last year, and the ACC offered conditional support for it at that time.

MedPAC Recommends Modest Increase in 2004 Medicare Physician Fees
The Medicare Payment Advisory Commission, in its 2003 report to Congress, recommended that physicians' 2004 Medicare fees be increased by 2.5 percent. The AMA has estimated that physicians' face a 1 percent cut in Medicare fees for 2004. Physicians had been facing a nearly 6 percent cut in 2004 fees prior to Congress' passage of the 2003 omnibus budget package. The College will continue to work with other physician organizations to secure administrative and legislative changes to prevent this reduction, while also focusing on broader reforms to the Medicare system.

CMS Makes Updates to Cardiology Codes for 2003 Medicare Fee Schedule
The Centers for Medicare and Medicaid Services (CMS) has released a Program Memorandum (AB-03-035) that includes several updates to cardiology codes for the 2003 Medicare physician fee schedule. These changes are effective March 1. According to the memorandum, congenital echocardiography codes 93315, 99315-TC, 93317, and 93317-TC have been changed to carrier pricing for 2003. Tilt table testing, CPT code 93660, has been changed from personal-supervision status to direct-supervision status. Finally, the new CPT code for biventricular pacing, 33224, has been corrected to a zero-day global period. The CMS initially had erroneously listed it as a 90-day global period. The ACC had requested the last two changes and is investigating why the changes to the congenital echo codes were made.

75 Million Uninsured At Some Point in 2001-2002
Approximately 75 million Americans under 65 years of age were uninsured sometime in 2001 and 2002, according to a report released last week. The report estimates that 65 percent were uninsured for at least six months and 24 percent were uninsured throughout the two-year period. In nine states, more than one out of three nonelderly Americans were estimated to be uninsured in the two-year period, and approximately four out of five of the uninsured were in working families. The report was released by The Robert Wood Johnson Foundation to kickoff Cover the Uninsured Week, a broad national campaign to raise awareness about the plight of the nation's uninsured. The ACC has joined with hundreds of other medical, business, and faith-based organizations to sponsor the initiative.

HHS to Rely On 'Voluntary Compliance' for Enforcing HIPAA Privacy Regs
The HHS Office of Civil Rights (OCR) will primarily rely on "voluntary compliance" to police whether health care providers are abiding by the HIPAA regulations on medical records privacy, which are set to take effect on April 14. "OCR's goal is not to maximize enforcement. Our goal is to protect personal health information," OCR director Richard Campanelli said last week at a HIPAA conference. According to a Modern Physician report, most enforcement activities will be driven by complaints, Campanelli said.

Updated ACC HIPAA Privacy Manual Now Available
In related news, an updated version of the ACC HIPAA Privacy Manual, revised to reflect the most recent changes to the final HIPAA privacy rule, is now available. The Manual, which is available for free to ACC members, offers easy-to-understand explanations of the privacy regulation and step-by-step instructions for becoming compliant. It also contains standardized forms, including the notice of privacy practices, authorization for nonroutine disclosures of information, and privacy contracts for use with "business associates." Hard copies can be obtained by contacting the ACC Resource Center at 800-253-4636, ext. 694. It is also available electronically on the ACC Web site.